Intra Uterine Insemination (IUI)
- Intrauterine insemination treatment, which is also known as inoculation, is one of the most common treatments applied to childless couples.
- Rationale of the technique is to grow 1 or 2 follicles with ovarian stimulation, to trigger ovulation, to inject best selected portion of the semen and to inject them into the uterine cavity in the presence of bilateral functional Fallopian tubes.
- Insemination is applied to patients whose sperm count, structure and activity is below normal. Before applying inoculation, sperm sample taken from the male is investigated in detail in terms of count, activity, structure and anti-sperm antibodies. It is necessary to assess whether the tubes of the patient are open with uterine x-ray. this operation, drugs can be used to stimulate the ovaries of the patient.
- With this application, the chance of multiple pregnancy increases.
- Ultrasonographic examinations are performed within the medication period and development of ovum is monitored and hCG injection (vaccine which enables cracking of the follicle) is made when the diameter of the follicle in which the ovum is reaches 18-20 mm. I
- Insemination is made 34-38 hours later. On the day of application, the sperm taken from the male is prepared with special methods and its activity and structure is improved. During inoculation, it is inconvenient to use the sperm without being prepared. This may cause allergic reactions, infections and pain in the female. The prepared sample is introduced into the uterus of the patient by means of special catheter. The chance of success is higher in women who menstruates regularly, whose tubes are open and who do not have endometriosis and are below 35. The chance of pregnancy with inoculation is around 15-20% in each application.
- Best results with IUI are achieved when the number of total motile sperm in the insemination
specimen exceeds a threshold of approximately 10 million and 14% or more of sperm have normal morphology (strict criteria; WHO III standard).
- Higher counts do not further increase the likelihood for success and IUI is seldom successful when fewer
than 1 million total motile sperm are inseminated.
- Success rates with IUI are best when
14% or more of sperm have normal morphology (strict criteria), intermediate with values between 4% and 14%, and generally quite poor when fewer than 4% of sperm are normal.
- The likelihood of success with IUI also decreases with increasing female partner age and with coexisting infertility factors (ovulatory dysfunction, uterine and tubal factors).
- When IUI is not possible, the prognosis for success with IUI is poor, or IUI proves unsuccessful and therapeutic donor insemination is rejected, IVF is the logical alternative.